Update of the Legislators' Guide To Video Lottery Terminal Gambling

Chapter 7. Social Costs and Economic Development Effects of Gambling 36
New
Gaming
Availability
Pre-Existing
Gambling
Exposure
Source: Department of Legislative Services
A
Exhibit 7.3
Standard Model of Gambling Costs
Change in
Gambling
Exposure
D
B
Other
Causes
E
Change in
Pathology
C
Other
Causes
Change in
Social Costs
This estimation technique has several problems. First, while it is plausible that increasing
gambling availability increases pathological and problem gambling, the magnitude of the change
is unclear. In addition, estimates may not consider pre-existing gambling exposure and patterns.
In Maryland, pre-existing gambling exposure includes legal and illegal gambling within the
State, as well as video lottery terminals (VLTs) accessible to Marylanders in nearby states.
Given evidence of significant gambling in surrounding states by Marylanders, it is likely that
Maryland already bears some burden of gambling social costs.
Another serious flaw is the problem of comorbidity amongst gamblers. Comorbidity
refers to the problem that pathological gamblers often have co-occurring addictions or mental
health problems. Referring to ill social effects, the U.S. General Accounting Office (GAO) in a
report in 2000 stated that “because pathological gambling in many cases is accompanied by other
disorders, it is difficult to determine whether gambling is the only or primary factor causing these
problems” to the extent that “even when an individual acknowledges that gambling contributed
to a particular family or social problem, it is extremely difficult to determine exactly what caused
the problem.” Numerous studies have established that pathological gamblers often have other
behavioral disorders including personality disorders, substance abuse, and mood disorders or
have experienced trauma in their lives. One study estimates that 78.0 percent of pathological
gamblers reported other addictive or psychiatric problems, and 38.5 percent stated that addictive
and psychiatric problems had increased the severity of their gambling. Gamblers can have other
problems irrespective of their gambling activities that make them more prone to generating
social costs. NRC conducted a critical review of the existing literature on problem and
pathological gambling in 1999. NRC stated that it is not clear whether or not some problems
observed in pathological gamblers may not be caused by gambling but by (for example) alcohol
abuse. NRC also stated that it is possible that pathological gambling is a symptom of other
underlying disorders that would show up in other ways if gambling were not available. Many
studies ignore comorbidity and, therefore, overestimate gambling social costs.
F